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全球、区域和国家宫颈癌及卵巢癌护理质量指数:1990 - 2019年全球疾病负担研究的系统分析

Global, regional, and national quality of care index of cervical and ovarian cancer: a systematic analysis for the global burden of disease study 1990-2019.

作者信息

Azangou-Khyavy Mohammadreza, Ghasemi Erfan, Rezaei Negar, Khanali Javad, Kolahi Ali-Asghar, Malekpour Mohammad-Reza, Heidari-Foroozan Mahsa, Nasserinejad Maryam, Mohammadi Esmaeil, Abbasi-Kangevari Mohsen, Ghamari Seyyed-Hadi, Ebrahimi Narges, Koolaji Sogol, Khosravifar Mina, Fateh Sahar Mohammadi, Larijani Bagher, Farzadfar Farshad

机构信息

Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, No. 10, Al-E-Ahmad and Chamran Highway Intersection, Tehran, Iran.

Social Determinants of Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

出版信息

BMC Womens Health. 2024 Jan 25;24(1):69. doi: 10.1186/s12905-024-02884-9.

Abstract

BACKGROUND AND OBJECTIVE

Cervical cancer is the most preventable and ovarian cancer is the most lethal gynecological cancer. However, in the world, there are disparities in health care performances resulting in differences in the burden of these cancers. The objective of this study was to compare the health-system quality of care and inequities for these cancers using the Quality of Care Index (QCI).

MATERIAL AND METHODS

The 1990-2019 data of the Global Burden of Disease (GBD) was analyzed to extract rates of incidence, prevalence, mortality, Disability-Adjusted Life Years (DALYs), Years of Life Lost (YLL), and Years of healthy life lost due to disability (YLD) of cervical and ovarian cancer. Four indices were developed as a proxy for the quality of care using the above-mentioned rates. Thereafter, a Principal Components Analysis (PCA) was applied to construct the Quality of Care Index (QCI) as a summary measure of the developed indices.

RESULTS

The incidence of cervical cancer decreased from 1990 to 2019, whereas the incidence of ovarian cancer increased between these years. However, the mortality rate of both cancers decreased in this interval. The global age-standardized QCI for cervical cancer and ovarian cancer were 43.1 and 48.5 in 1990 and increased to 58.5 and 58.4 in 2019, respectively. QCI for cervical cancer and ovarian cancer generally decreased with aging, and different age groups had inequitable QCIs. Higher-income countries generally had higher QCIs for both cancers, but exceptions were also observed.

CONCLUSIONS

Uncovering disparities in cervical and ovarian cancer care across locations, Socio-Demographic Index levels, and age groups necessitate urgent improvements in healthcare systems for equitable care. These findings underscore the need for targeted interventions and prompt future research to explore root causes and effective strategies for narrowing these gaps.

摘要

背景与目的

宫颈癌是最可预防的妇科癌症,而卵巢癌是最致命的妇科癌症。然而,全球在医疗保健服务方面存在差异,导致这些癌症的负担有所不同。本研究的目的是使用医疗质量指数(QCI)比较这些癌症的医疗系统质量和不公平性。

材料与方法

分析全球疾病负担(GBD)1990 - 2019年的数据,以提取宫颈癌和卵巢癌的发病率、患病率、死亡率、伤残调整生命年(DALYs)、生命损失年数(YLL)以及因残疾导致的健康生命损失年数(YLD)。利用上述比率制定了四个指数作为医疗质量的替代指标。此后,应用主成分分析(PCA)构建医疗质量指数(QCI),作为所制定指数的综合衡量指标。

结果

1990年至2019年,宫颈癌发病率下降,而卵巢癌发病率在此期间上升。然而,这两种癌症的死亡率在此期间均下降。1990年宫颈癌和卵巢癌的全球年龄标准化QCI分别为43.1和48.5,到2019年分别增至58.5和58.4。宫颈癌和卵巢癌的QCI一般随年龄增长而下降,不同年龄组的QCI存在不公平现象。高收入国家这两种癌症的QCI通常较高,但也存在例外情况。

结论

揭示宫颈癌和卵巢癌在不同地区、社会人口指数水平和年龄组之间的医疗差异,需要紧急改善医疗系统以实现公平医疗。这些发现强调了有针对性干预的必要性,并促使未来开展研究以探索缩小这些差距的根本原因和有效策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7027/10809627/b07340ae6238/12905_2024_2884_Fig1_HTML.jpg

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